Complete Lower Arch Build-up of Very Worn Down Teeth

Opening of the bite on very worn down teeth due to a grinding habit, and acid reflux. Beautifully restored with composite (filling material), for a truly conservative approach. To be followed by Emax porcelain veneers on the 6 front lower teeth in a few months.

Presenting appearance & background

This patient from Gibraltar presented to our practice with a heavily worn down appearance due to both grinding her teeth at night, but also because of a stomach acid reflux problem.

She was concerned that her front lower teeth were starting to look short and stumpy, as well as more yellow, as the enamel was being worn away, and the yellow dentine was shining through.

Option 1: Crown Lengthening Surgery

Option 2: Building Up the Bite, Raising Vertical Dimension

Planning phase

In order to achieve a more elegant slender appearance of her lower front teeth, we would have to create space either by opening up her entire bite, or doing some crown lengthening gum surgery (or a combination of both).

After consultation with the patient we decided the best and most conservative option was to open the bite with composite (filling material) only. She did not wish to have crowns, nor touch the top teeth at this stage. After opening the bite, and stabilising the new dimensions, for optimal aesthetics on the lower front 6 teeth we will soon place Emax porcelain veneers.

Lower arch before composite build up

We preformed this work under rubber dam for optimal moisture isolation, and a clean working environment.

After lower arch composite build up

After careful wax ups and planning, we opened the entire bite just enough to allow for the correct size and shape of her front teeth. The week after we also built up her upper back teeth for ideal occlusion (biting). In a few months we will complete the case with lower Emax porcelain veneers on the six front teeth.